SEMIO CH10 TRIGGER

NEUTROPHILS F°

BACTERIAL DEFENSE

LYMPHOCYTES F°

ADAPTATIVE IMMUNITY

VIRUS DEFENSE

MONOCYTES F°

PHAGOCYTOSIS

EOSINOPHILS F°

PARASITES + ALLERGY

NORMAL WBC VALUES

4K-11K

% NEUTROPHILS

50-70%

% LYMPHOCYTES

20-40%

% MONOCYTES

2-8%

% EOSINOPHILS

1-4%

WBC >11,000

LEUKOCYTOSIS

WBC LOW

LEUKOPENIA

NEUTROPHILS LOW

NEUTROPENIA

ABSOLUTE / RELATIVE NEUTROPENIA

LESS THAN 1800/MM3

LESS THAN 40%

CENTRAL NEUTROPENIA DUE TO

BONE MARROW PROBLEM

PERIPHERAL NEUTROPENIA DUE TO

NEUTROPHILS DESTRUCTIONS IN BLOOD / SPLEEN

NEUTROPHILS <500 TRIGGER

SEVERE NETROPENIA

HIGH INFECTION RISK

HIGH SEPSIS RISK

TRIGGER : NEUTROPENIA + ORAL ULCERS / PERIDONTAL PROBLEMS

IMPAIRED BACTERIAL DEFENSE

NEUTROPHILS ↑

NEUTROPHILIA

ABSOLUTE / RELATIVE NEUTROPHILIA

→ >7,500

→ >75%

MAIN CAUSE NEUTROPHILIA ?

ACUTE BACTERIAL INFECTION

DIFFERENCE SEG VS BAND

SEG = MATURE NEUTRO°

BAND = IMMATURE NEUTRO°

LEFT SHIFT

NEUTROPHILIA + BANDS ↑

DIFFERENCE QUAND SEGS ↑ VS QUAND BANDS ↑

QUAND SEGS ↑ → BACTERIAL INFECTION

QUAND BANDS ↑ → SEVERE BACTERIAL INFECTION

LYMPHOCYTES ↓ =

LYMPHOPENIA

ABSOLUTE / RELATIVE LYMPHOPENIA

→ <1,500

→ <20%

MAIN CAUSE LYMPHOPENIA

PATIENT WITH HIV

HIV DESTROY ?

LYMPHO° CD4

WHEN CD4 <400

OPPORTUNISTIC INFECTION RISK +

WHEN CD4 <200

SEVERE OPPORTUNISTIC INFECTION RISK ++

ABSOLUTE LYMHOCYTOSIS

>3,500

2 VIRAL INFECTIONS ASSOCIATED W/ LYMPHOCYTOSIS

EBV / CMV

OLD PATIENT + PERSISTENT LYMPHOCYTOSIS TRIGGER

CHRONIC LYMPHOCYTIC LEUKEMIA

ABSOLUTE / RELATIVE EOSINOPHILIA

>450

>3%

3 MAIN CAUSE EOSINOPHILIA

PARASAITE / ALLERGY / DRUG REACTION

LEUKEMIA DEF

MALIGNANT NEOPLASM FROM IMMATURE HEMATOPOIETIC PRECURSOR CELLS IN THE BONE MARROW

2 LINEAGES OF LEUKEMIA

MYELOID / LYMPHOCYTIC

DIFFERENCE -BLAST / -CYTIC FOR LEUKEMIA CLASSIFICATION

-BLAST → IMMATURE CELLS → ACUTE LEUKEMIA

-CYTIC → MATURE CELLS → CHRONIC LEUKEMIA

LEUKEMIA CAUSES ? ASSOCIATED SYMPTOMS

ANEMIA = ASTHENIA + PALLOR

LEUKOPENIA = INFECTION RISK ++

THROMBOCYTOPENIA = BLEEDING RISK ++

LEUKEMIA SPREAD → LIVER

HEPATOMEGALY

LEUKEMIA SPREAD → SPLEEN

SPLENOMEGALY

LEUKEMIA SPREAD → LYMPH NODES

ADENOPATHY

TRIGGER ORAL MANIFESTATIONS OF LEUKEMIA

GINGIVAL ELARGEMENT + BLEEDING + INFECTIONS

LYMPHOMA DEF

MALIGNANT NEOPLASM OF LYMPHOCYTES ORIGINATING IN LYMPH NODES

3 TERMES POUR ENLARGED LYMPH NODES

ADENOPATHY

LYMPHADENOPATHY

LYMPHADENOMEGALY

LYMPHADENOPATHY → PAINLESS + HARD + FIXED =

MALIGNANT

LYMPHADENOPATHY → PAINFUL + SOFT + MOBILE

BENIGN

2 MAIN CAUSE OF BENIGN LYMPHADENOPATHY

VIRUS / INFLAMMATORY

VIRUS PRINCIPALEMENT ASSOCIÉ À LYMPHADENOPATHY ?

EPSTEIN BARR VIRUS → INFECTE LYMPHOCYTES B → REACTIVE LYMPHADENOPATHY

PRIMARY MALIGNANT LYMPHADENOPATHY

LYMPHOMA → CANCER DES LYMPHOCYTES

2 TYPES OF LYMPHOMA

HODGKIN OR NON HODGKIN

HODGKIN LYMPHOMA WHEN PRESENCE OF

REED STERNBERG CELL → OWL EYES SHAPED

HODGKIN LYMPHOMA = MALIGNANGY OF ?

MALIGNANCY OF MATURE LYMPHOCYTES B

HODGKIN STAGE I

1 LYMPH NODE REGION AFFECTED

HODGKIN STAGE II

2+ LYMPH NODES REGION AFFECTED

→ BUT ON THE SAME SIDE OF THE DIAPHRAGM

HODGKIN STAGE III

LYMPH NODES AFFECTED ON BOTH SIDES OF THE DIAPHRAGM

HODGKIN STAGE IV

EXTRANODAL DEPOSITS → LIVER OR BONE MARROW INVOLVEMENT

HODGKIN TYPE A

NO SYMPTOMS

HODGKIN TYPE B

WEIGHT LOSS >10%

FEVER >38°C

NIGHT SWEATS

LEUKEMIA DIAGNO° TRIGGER

BONE MARROW BIOPSY / ASPIRATION (PONCTION)

LYMPHOMA DAGNO° TRIGGER

LYMPH NODE BIOPSY + FNA

HARD + PAINLESS + PERSISTANT CERVICAL LYMPH NODE →

MALIGNANT LYMPHADENOPATHY (LYMPHOMA IF PRIMARY)

TRIGGER CHILD W/ MYELOBLASTS +++

ACUTE MYELOID LEUKEMIA

IGM + / IGG -

RECENT / ACUTE INFECTION

CD4/T4 ↓

HIV